AAFP Offers Guidance on FDA Tobacco Regulation

Agency Seeks Public Input on New Authority

By News Staff
11/5/2009

The AAFP has weighed in with numerous suggestions to a July request from the FDA for public input on how the agency should implement its newfound authority to regulate tobacco.

The FDA gained the authority to regulate the manufacture, marketing and distribution of tobacco products to protect public health and reduce tobacco use in minors when President Obama signed the Family Smoking Prevention and Tobacco Control Act in June.

In its comments, the AAFP lauded the agency's recent ban on cigarettes with fruit, candy or clove flavoring and suggested the agency go a step further by forcing manufacturers to remove menthol as a flavoring agent.

The Academy also recommended that the FDA

ban single sales of little cigars to reduce initiation of smoking among adolescents;
broaden restrictions on misleading information on cigarette packaging;
implement pictorial warnings on packaging as a way to broaden communication about the hazards of tobacco use in other countries;
restrict the use of colors, package design and other attempts to appeal to smokers "through allusions to virility, femininity, glamour," etc.;
diminish the appeal of tobacco at the point of sale, for example, by requiring that products be sold under the counter; and
help educate physicians, nurses and other health care providers about tobacco cessation and control.

Academy Ramps Up Stance on Tobacco Cessation, Prevention

The AAFP revised its policy statement on tobacco and smoking and issued a new position paper on tobacco use, prevention and cessation during its annual Congress of Delegates, Oct. 11-14 in Boston.

The revised policy statement calls for a ban on the sale of tobacco products in facilities that provide clinical patient care services, pharmacies and retail outlets with health clinics.

The statement also expanded on the Academy's stance on smoking in movies, calling on the film industry to take the following voluntary steps:

require movies that contain scenes depicting smoking to have an "R" rating unless the presentation of tobacco clearly reflects the dangers and consequences of use or tobacco use is necessary to represent smoking by a historical figure;
require producers to certify on screen that no one in the production received anything of value in consideration for using tobacco;
require antismoking ads before all movies that include tobacco use; and
stop identifying tobacco brands.

The statement also supports the World Health Organization's Framework Convention on Tobacco Control treaty and urges its ratification by the Senate and signature by President Obama.

In its comments, the Academy also expressed hope that FDA officials would find a way to minimize the influence of three, nonvoting, tobacco industry representatives on its Tobacco Products Scientific Advisory Committee. Those three spots are guaranteed to the industry under the new law, but the Academy cautioned the FDA to limit the role those representatives play.

"Representation by the tobacco industry on National Cancer Institute panels in the past has proven to be detrimental to the work of the agency," the AAFP wrote. "The mission of the FDA and that of the tobacco industry are diametrically opposed, and their presence on the committee will compromise the objectivity of the committee's decisions and tend to create at least an appearance of a conflict of interest."

The Academy also urged the FDA to use caution in setting new standards for tobacco and not allow the industry to make minor, drawn-out changes that accomplish little for public health.

The agency is accepting comments on its new regulatory authority through Dec. 28.

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